[1]刘伟*,杨鹏,赵余晓.腹腔镜辅助诊治小肠肿瘤24例报告[J].中国微创外科杂志,2017,17(10):933-935.
　Liu Wei,Yang Peng,Zhao Yuxiao..Laparoscopic Diagnosis and Treatment of Small Bowel Tumors in 24 Patients[J].Chinese Journal of Minimally Invasive Surgery,2017,17(10):933-935.
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腹腔镜辅助诊治小肠肿瘤24例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年10期
页码:
933-935
栏目:
经验交流
出版日期:
2017-10-20

文章信息/Info

Title:
Laparoscopic Diagnosis and Treatment of Small Bowel Tumors in 24 Patients
作者:
刘伟*; 杨鹏; 赵余晓
台州恩泽医疗中心集团路桥医院普外科，台州318050
Author(s):
Liu Wei;  Yang Peng;  Zhao Yuxiao.
Department of General Surgery, Luqiao Hospital of Taizhou Enze Medical Center Group, Taizhou 318050, China
关键词:
腹腔镜; 小肠肿瘤
Keywords:
Laparoscope; Small intestinal tumor
文献标志码:
B
摘要:
目的探讨腹腔镜在小肠肿瘤诊治中的价值。方法脐孔穿刺建立气腹，置入腹腔镜，于左右腹直肌外侧缘各置入5 mm trocar。探查明确小肠肿瘤的部位，上腹正中线或下腹正中做长3~4 cm切口，切口保护器保护切口，良性肿瘤行小肠局部切除, 恶性肿瘤行根治性切除，端端或侧侧吻合肠管，关闭小肠系膜孔，缝合穿刺孔。结果24例均在腹腔镜下诊断和手术，其中23例腹腔镜辅助下行部分小肠肠段切除，1例行腹腔镜辅助下右半结肠切除。手术时间 (70.3±21.7) min，术中出血量 (18.5±3.1) ml，切口长度(3.5±1.1) cm，术后肛门排气时间为(2.5±0.5) d。术后病理：良性肿瘤8例，平滑肌瘤多见，5例；恶性肿瘤16例，间质瘤多见，6例。术后住院时间 (6.5±2.5) d。19例随访0.5~4.5年，平均2.6年，其中良性肿瘤6例，恶性肿瘤13例，1例小肠腺癌腹腔内广泛转移死亡，其余18例无肿瘤复发。结论腹腔镜不仅能明确小肠肿瘤的诊断，处理小肠肿瘤安全可行。
Abstract:
ObjectiveTo evaluate the clinical value of laparoscopy in the diagnosis and surgical treatment of small intestinal tumors.MethodsAfter the establishment of pneumoperitoneum with umbilicus puncture, a laparoscope was inserted. Two 5-mm trocars were placed through lateral right and left rectus abdominis to explore the location of the small intestine tumors. A 3-4 cm incision was made along the abdominal midline or lower abdomen median. With the use of incision protector, benign tumors were given local excision of small intestine, or malignant tumors were given radical resection. End to end or side to side anastomosis of bowel was carried out, and then the mesenteric hole was closed and the puncture hole sutured.ResultsAll the patients were diagnosed and treated by laparoscopic procedure successfully, including 23 cases of laparoscopic-assisted partial intestinal resections and 1 case of right hemicolectomy. The mean operative time was (70.3±21.7) min, the mean blood loss was (18.5±3.1) ml, the mean length of incision was (3.5±1.1) cm, and the mean time for passage of flatus was (2.5±0.5) d. Postoperative pathological examinations showed benign tumors in 8 cases, most of which were leiomyoma (5 cases), and malignant tumors in 16 cases, most of which were stromal tumors (6 cases). The postoperative hospital stay was (6.5±2.5) d. Follow-ups were conducted for 0.5-4.5 years (mean, 2.6 years) in 19 cases, including 6 cases of benign tumor and 13 cases of malignant tumor. No recurrent tumor was found except one fatal case of advanced intestinal carcinoma.ConclusionLaparoscopic exploration can diagnose small intestinal tumors accurately, and laparoscopic-assisted surgical treatment is safe.

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备注/Memo

备注/Memo:
*通讯作者，E-mail：liuwei_x@163.com
更新日期/Last Update: 2018-01-11